Czech and Slovak Ophthalmology424OthersRecommended Procedures for Diagnosis and Treatment of Diabetic RetinopathyKalvodováBohdanaSosnaTomášPelikánováTerezie212201666
Czech Ophthalmological Society, CMS JEP (COS) Czech Diabetological Society, CMS JEP (CDS)Czech Vitreoretinal Society (CVRS)
ReferencesJones, S., E dwards, R.T.: Diabetic retinopathy screening: a systematic review of the economic evidence. Diabet Med, 27; 2010: 249–256.Kalvodová, B.: Diabetická oftalmopatie. In Škrha J. (Ed), Diabetologie. Praha, Galén, 2009, s. 177–188.Sosna, T., Bouček, P., Fišer, I.: Diabetická retinopatie - diagnostika, prevence, léčba, Praha, Cendelín, 2001, 255 s.Aiello, L.P., Gardner, T.W., King, G.L. et al.: Diabetic retinopathy. Diabetes Care, 21; 1998: 143–156. cular edema disease severity scales. Ophthalmology, 110, 2003: 1677–1682.Sosna, T.: Diabetická retinopatie - rizikové faktory, prevence a terapie. Čes a slov Oftalmol, 66; 2010: 195–203.Murphy, R.P.: Management of diabe - tic retinopathy. Am Fam Physician, 51; 1995: 785–796.PREVENTION, SCREENING Prevention of the occurrence and progression of DR may be implemented upon the precondition of professional co -operation of diabetologists, internists, general practitioners and ophthalmologists. The aim of diabetological treatment in patients with DM in relation to prevention and stabilisation of DR is timely (risk of metabolic memory), long-term and satisfactory compensation of DM, control of hypertension and other risk factors. The diabetologist recommends patients with DM for an examination by an ophthalmologist at the time of determination of diagnosis of both types of DM (characteristics of DR and DMP may already be present), and further at minimum 1x per year. The ophthalmologist is then responsible for the timely identification of DR, records diabetics with DR, calls upon them to attend regular examinations and ensures specialised ophthalmological treatment. Screening of retinopathy is performed by an ophthalmologist on children and adolescents once per yASSESSMENT PER SPECTIVES IN OCULAR COMPLICATIONS OF DR Advanced stages of DR which significantly reduce visual acuity or limit the scope of the visual field are indications for acknowledging partial or full invalidity with reference to specific circumstances in individual patients according to the relevant decrees. Practical blindness in both eyes is visual acuity of 1/60 with best possible correction or 1/50 to light sense or limitation of visual field up to 5 degrees around central fixation, even if central sharpness is not affected. Complete blindness in both eyes is loss of sight covering states from absolute loss of light sense to preservation of light sense with faulty light projection. Peroral antidiabetic agents – glitazones An adverse side effect of glitazones such as rosiglitazone and pioglitazone is retention of fluid in tissues. 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N Engl J Med, 329; 1993: 977–986.Holman, R.R., Paul, S.K., Bethel, M.A. et al.: Long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med, 359; 2008: 1565– 1576.Chaturvedi, N., Sjolie, A.K., Stephenson, J.M. et al.: Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. The EUCLID Study Group. EURODIAB Controlled Trial of Lisinopril in Insulin -Dependent Diabetes Mellitus. Lancet, 351; 1998: 28–31.Keech, A.C., Mitchell, P., Summanen, P.A. et al.: Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. Lancet, 370; 2007: 1687–1697.Chew, E.Y., Ambrosius, W.T., Davis, M.D. et al.: Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med, 363; 2010: 233–244.Kalvodová, B., Sklenka, P. et al.: Diagnostika a léčba diabetické retinopatie a jejich komplikací. DMEV, 2002: 214– 218.Studnička, J.: Indikace ranibizumabu v oftalmologii. Remedia, 22; 2012: 341– 344.Yanagida, Y., Ueta, T.: Systemic safety of ranibizumab for diabetic macular edema: meta-analysis of randomized trials. Retina, 34; 2014: 629–635.Brown, D.M., Schmidt-Erfurth, U., Do, D.V. et al.: Intravitreal Aflibercept for Diabetic Macular Edema: 100-Week Results From the VISTA and VIVID Studies. Ophthalmology, 122; 2015, 2044–2052.Korobelnik, J.F., Do, D.V., Schmidt-Erfurth, U., Boyer, D.S., et al.: Intravitreal aflibercept for diabetic macular edema. Ophthalmology, 121; 2014: 2247–2254.Evans, M., Katz , T.A., Crane, M.: Effects of baseline haemoglobin A1c and on -treatment blood pressure on outomes in the VIVID-ME and VISTA-ME studies. Diabetologia, 58 (Suppl. 1); 2015: 235.Boyer, D.S., Yoon, Y.H., Belfort, R., Jr. et al.: Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. 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